Chapter 5:
The Emergence of Enterovirus-D68

Affiliations: 1: University of Colorado School of Medicine, Department of Pediatrics, Section of Infectious Disease, and Section of Hospital Medicine, Aurora, CO 80045;
2: University of Colorado School of Medicine, Department of Pediatrics, Section of Infectious Disease, Aurora, CO 80045;
3: University of Colorado School of Medicine, Department of Pediatrics, Section of Infectious Disease, and Section of Hospital Medicine, Aurora, CO 80045;
4: University of Colorado School of Medicine, Department of Pediatrics, Section of Infectious Disease, and Section of Hospital Medicine, Aurora, CO 80045

Enteroviruses are some of the most common human viral pathogens. Although infections are often asymptomatic, enteroviruses are capable of causing a wide spectrum of illness. They cause mild and self-limited, often febrile illness, hand-foot-and-mouth disease, herpangina, conjunctivitis, pleurodynia, hepatitis, myocarditis, sepsis, meningitis, encephalitis, and acute flaccid paralysis (1). Disease can be particularly severe in neonates and the immuncompromised (2). Historically, enteroviruses have been uncommonly associated with severe respiratory disease (1).

Number of visits for respiratory illness to the Children’s Hospital Colorado emergency department requiring hospital admission and the cases of acute flaccid myelitis during the 2014 EV-D68 outbreak. Visits with a chief complaint of respiratory symptoms requiring hospital admission from the week ending 2 August 2014 (week 31) to that ending 25 October 2014 (week 43) compared with the same timeframe for 2012–2013 and the timing of the cases of acute flaccid myelitis. Reprinted from reference 60, with permission.

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Figure 2

Number of visits for respiratory illness to the Children’s Hospital Colorado emergency department requiring hospital admission and the cases of acute flaccid myelitis during the 2014 EV-D68 outbreak. Visits with a chief complaint of respiratory symptoms requiring hospital admission from the week ending 2 August 2014 (week 31) to that ending 25 October 2014 (week 43) compared with the same timeframe for 2012–2013 and the timing of the cases of acute flaccid myelitis. Reprinted from reference 60, with permission.